Vincent Ng'ethe ANALYSIS: Why figures for Kenya’s road death toll vary

Different sources put Kenya road death toll between 3,000 and 13,000 lives lost per year. Why does it vary so much and which figure is most accurate?

The answer to just how many people die on Kenya’s roads depends on who you ask.

The country’s national transport authority put it at 2,965 for 2016, while the official statistics agency had it as 4,809 people. Then there’s the World Health Organisation, which says between 3,000 and 13,000 Kenyans die each year on the country’s roads.

What explains the variation and which one is the closest to right?

Transport authority’s numbers from police

A passenger is helped from the wreckage of a bus that collided with a lorry in Nairobi in January 2018. Photo: AFP/TONY KARUMBA
A passenger is helped from the wreckage of a bus that collided with a lorry in Nairobi in January 2018. Photo: AFP/TONY KARUMBA

Kenya’s transport regulator, the National Transport and Safety Authority (NTSA), told Africa Check they only report police data. However, underreporting is a concern, as the police need to follow up on injured people, the authority’s Nairobi manager for strategies, Samuel Musumba, noted.

Police spokesman Charles Owino told Africa Check the police are supposed to update their reports.

“If a person dies while being treated, we do a follow-up report. We add the death to our list of fatalities until all the injured persons are discharged and we know there are no more fatalities,” Owino said.

“I want to believe that it is done well, unless a question arises, for example due to differences with registration figures. Then we would go back to investigate the particular police station.”

Proper records a headache, says civil registration

Kenya’s health ministry has a civil registration and vital statistics unit that collects data on births and deaths. This information is then shared with the official data agency.

But inaccurate records are a major headache, the head of the unit, Samuel Cheburet, told Africa Check.

“A person is involved in an accident and is admitted to hospital where they create files [for them]. The patient can develop other complications and the hospital can manage those. So the records say a ruptured spleen was the cause of death, but they are not telling us it was an accident that gave rise to that.”

WHO employs statistical modelling

The World Health Organisation’s death toll of 3,000 and 13,000 is not supposed to a range, but two separate sources of data, Dr Margie Peden told Africa Check. She is an associate at the Bloomberg School of Public Health at Johns Hopkins University and until recently coordinated the unintentional injury prevention section at the WHO.

The number of  “approximately 3,000” comes from the road traffic deaths that the Kenyan government supplies to the WHO, based on police data.

But the WHO also works from Kenya’s death certificate data, but Peden noted it is “not as well covered as we would like it to be”. Fewer than half of all deaths in Kenya were registered between 2012 and 2016.

“We know that most countries around the world have an issue with underreporting, ranging from a small percentage in high-income countries to 50%-70% in some low and middle-income countries,” she said.

“Very often when you look at police data there is an urban bias, so that deaths are reported in the urban areas but in the deep rural areas that reporting doesn’t happen to the same degree. There are sometimes political and cultural reasons why deaths are not reported to the police.”

Therefore the WHO applies a statistical model to the health ministry’s data. It takes into account twelve variables “that are known to be predictive of road deaths”, such as road density, speed limits and alcohol consumption.

By this calculation, the WHO’s best estimate is that 12,891 people died on Kenya’s roads in 2013, with the organisation 95% sure that the total lies between 10,809 and 14,974 people during that year.

Kenya in world’s bottom 20

If only police data was used to compute a death rate per 100,000 people in Kenya, the country’s roads would rank as some of the safest in the world, Peden added.

“I don’t believe that’s a possibility,” Peden said.

Africa Check calculated the 2013 death rate at 7.7 per 100,000 people based on police data and the statistics agency’s population estimate for that year. This rate places Kenya in the company of countries like Hungary and Estonia.

But the WHO estimated Kenya’s death rate at 29.1 per 100,000 people for 2013, which landed Kenya in the worst twenty countries worldwide for road deaths.

Kenya’s transport authority told Africa Check they are seeking to increase the accuracy of their data. “We are trying to improve our data so we do not only rely on the police,” Musumba said. “We want to have an agreement with the ministry of health so that we can share more information.”

Until Kenya’s road death data better reflects reality, commentators must keep the current uncertainty in mind.

How Kenya can reduce road deaths

The Kenyan government needs to do more to protect vulnerable road users, Dr Eric Thuo, a post-doctoral fellow with the Johns Hopkins International Injury Research Unit, said.

“The highest number of deaths are among pedestrians, but mostly when we have these conversations, it’s because a bus crashes and 20 people die [at once]. If your burden of pedestrians is 45% to 50%, you might have big wins if you focus on that.”

Helmets that both meet international safety standards and are suitable for tropical climates like Kenya’s are also important, Dr Abdulgafoor Bachani told Africa Check.

Bachani co-authored a study which examined the use of helmets among motorcycle users in two urban areas of Kenya.

From observing 256,851 motorcycle users between August 2010 and December 2014, the researchers found that fewer than 40% of motorcycle drivers in the ares of Thika and Naivasha wore helmets. Among passengers, it dropped to a paltry 2.77% in Thika and 2.43% in Naivasha.

According to the study, laws requiring mandatory use of helmets have only resulted in small gains. Passengers, in particular, complain that helmets are inconvenient, uncomfortable or unhygienic.

“Interventions such as the provision of hair nets or use of disinfecting spray by motorcycle taxis and mass media campaigns addressing these specific issues need to be considered in addition to enhanced enforcement of the legislation,” the study stated.

Also, Kenya’s blood alcohol limit of 0.08 g alcohol per decilitre of blood is higher than the international guideline of 0.05 g/dl and should be reviewed, Thuo said.

 

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